Buried Alive?

An NYT op-ed calling for loosening the definition of death has proven immensely unpopular.

Communist lyricist Bertolt Brecht (“Mack the Knife”) before having a stiletto driven through his no longer beating heart

From the New York Times opinion section:

Donor Organs Are Too Rare. We Need a New Definition of Death.

July 30, 2025

By Sandeep Jauhar, Snehal Patel, and Deane Smith

Dr. Jauhar is a cardiologist at Northwell Health in New York, where Dr. Patel and Dr. Smith are the directors of the center for heart failure and transplant.

People die in many ways, but in medicine there are only two reasons a person can be declared dead: Either the heart has stopped or the brain has ceased to function, even if the heart is still beating.

A person may serve as an organ donor only after being declared dead. …

Most donor organs today are obtained after brain death, defined by most state laws as a condition of permanent unconsciousness with no spontaneous breathing, no response to pain and no primitive reflexes — in other words, devastation of the whole brain. Organs obtained this way are often relatively healthy, because brain-dead patients can continue to circulate blood and oxygen.

Brain death is rare, though. In New York State, with a population of 20 million, there are on average fewer than 500 cases suitable for organ procurement and transplantation each year.

Far more often, people die because their heart has permanently stopped beating, which is known as circulatory death. However, precisely because the blood has stopped circulating, organs from people who die this way are often damaged and unsuited for transplantation.

The need for donor organs is urgent. An estimated 15 people die in this country every day waiting for a transplant. We need to figure out how to obtain more healthy organs from donors while maintaining strict ethical standards.

New technologies can help. But the best solution, we believe, is legal: We need to broaden the definition of death. …

Fortunately, there is a relatively new method that can improve the efficacy of donation after circulatory death. In this procedure, which is called normothermic regional perfusion, doctors take an irreversibly comatose donor off life support long enough to determine that the heart has stopped beating permanently — but then the donor is placed on a machine that circulates oxygen-rich blood through the body to preserve organ function. Donor organs obtained through this procedure, which is used widely in Europe and increasingly in the United States, tend to be much healthier.

But by artificially circulating blood and oxygen, the procedure can reanimate a lifeless heart. Some doctors and ethicists find the procedure objectionable because, in reversing the stoppage of the heart, it seems to nullify the reason the donor was declared dead in the first place. Is the donor no longer dead, they wonder?

… The solution, we believe, is to broaden the definition of brain death to include irreversibly comatose patients on life support. Using this definition, these patients would be legally dead regardless of whether a machine restored the beating of their heart.

This has been one of the least popular op-eds in recent years.

I suspect the three well-meaning doctors don’t realize how many people are terrified of …

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